Cardiac Enzymes: CK-MB

Troponin Most specific for MI. it rises in 2-3h, lasts 7-10 days. <0.03 ng/mL normal. CK-MB: Markers for MI Rises in 3-6h, peaks at 24h, lasts 2-3 days.

Bad cholesterol. Transport choles to cells. Goal is 55 mg/dL, >45 mg/dL.

Transthoracic Echocardiogram

Noninvasive ultrasound to view heart structure/function, measure ejection fraction (EF).

Transesophageal Echo (TEE)

Transducer in esophagus provides clearer heart images. Requires sedation & NPO status.

P walks on treadmill assess heart under load. Monitor w/ 12-lead ECG. For ps who can't exercise, Meds (dobutamine, adenosine)

Hemodynamic Monitoring

Uses catheters to measure pressures (CVP, PAP, PAWP, CO) and assess fluid/ pump status.

Central Venous Pressure (CVP)

Measures R atrial pressure/ preload. Normal 2-6 mm Hg. High = fluid overload.

Pulmonary Artery Wedge Pressure (PAWP)

Measures L ventricular preload. Normal 6-15 mm Hg. High = L-sided HF.

Arterial Line Purpose

Provides continuous BP monitoring & allows arterial blood sampling. NOT for IV fluids.

Pulmonary Artery Catheter

Multi-lumen catheter threaded into PA. Measures PAP, PAWP, CO, SvO2.

Cardiac Catheterization (Angiography)

Invasive Dx for coronary artery blockage. Access via femoral/radial artery.

Post-Cath Nursing Care

Monitor VS, site for bleeding/hematoma, keep extremity straight, maintain bed rest.

Post-Cath Client Education

No heavy lifting, report chest pain/SOB, keep site dry, resume metformin as ordered.

Contrast media can cause reaction and nephrotoxic. Assess for iodine/shellfish allergy. Premedicate. Monitor urine output, BUN/Cr. Hold metformin for 48h.

Cardiac Tamponade Post-Cath

Rare complication from artery perforation. Sx: hypotension, JVD, muffled heart sounds.

Peripherally Inserted Central Catheter (PICC)

Long-term IV access (up to 12 mo). Inserted in arm, tip in SVC.

Use 10mL syringe to flush, cleanse port with alcohol, transparent dressing, no BP in that arm.

PICC Flushing Protocol

Flush with 10mL saline before/after meds, 20mL after blood draw, heparin for maintenance.

Surgically placed chest port for long-term access (>1 yr). Accessed with Huber (non-coring) needle.

Palpate septum, use Huber needle, check blood return, flush with heparin (100 units/mL).

Central Line Complications

Infection: Monitor site for redness/drainage. Use sterile technique for dressing changes. Occlusion don't force flush. Inflammation.

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Cardiac Testing

Question	Answer
Cardiac Enzymes: CK-MB	Troponin Most specific for MI. it rises in 2-3h, lasts 7-10 days. <0.03 ng/mL normal. CK-MB: Markers for MI Rises in 3-6h, peaks at 24h, lasts 2-3 days.
LDL v HDL	Bad cholesterol. Transport choles to cells. Goal is <130 mg/dL. Good cholesterol. Protects arteries. Goal >55 mg/dL, >45 mg/dL.
Transthoracic Echocardiogram	Noninvasive ultrasound to view heart structure/function, measure ejection fraction (EF).
Transesophageal Echo (TEE)	Transducer in esophagus provides clearer heart images. Requires sedation & NPO status.
Stress Test	P walks on treadmill assess heart under load. Monitor w/ 12-lead ECG. For ps who can't exercise, Meds (dobutamine, adenosine)
Hemodynamic Monitoring	Uses catheters to measure pressures (CVP, PAP, PAWP, CO) and assess fluid/ pump status.
Central Venous Pressure (CVP)	Measures R atrial pressure/ preload. Normal 2-6 mm Hg. High = fluid overload.
Pulmonary Artery Wedge Pressure (PAWP)	Measures L ventricular preload. Normal 6-15 mm Hg. High = L-sided HF.
Arterial Line Purpose	Provides continuous BP monitoring & allows arterial blood sampling. NOT for IV fluids.
Pulmonary Artery Catheter	Multi-lumen catheter threaded into PA. Measures PAP, PAWP, CO, SvO2.
Cardiac Catheterization (Angiography)	Invasive Dx for coronary artery blockage. Access via femoral/radial artery.
Post-Cath Nursing Care	Monitor VS, site for bleeding/hematoma, keep extremity straight, maintain bed rest.
Post-Cath Client Education	No heavy lifting, report chest pain/SOB, keep site dry, resume metformin as ordered.
Angiography Concerns	Contrast media can cause reaction and nephrotoxic. Assess for iodine/shellfish allergy. Premedicate. Monitor urine output, BUN/Cr. Hold metformin for 48h.
Cardiac Tamponade Post-Cath	Rare complication from artery perforation. Sx: hypotension, JVD, muffled heart sounds.
Peripherally Inserted Central Catheter (PICC)	Long-term IV access (up to 12 mo). Inserted in arm, tip in SVC.
PICC Line Care	Use 10mL syringe to flush, cleanse port with alcohol, transparent dressing, no BP in that arm.
PICC Flushing Protocol	Flush with 10mL saline before/after meds, 20mL after blood draw, heparin for maintenance.
Implanted Port	Surgically placed chest port for long-term access (>1 yr). Accessed with Huber (non-coring) needle.
Port Access & Care	Palpate septum, use Huber needle, check blood return, flush with heparin (100 units/mL).
Central Line Complications	Infection: Monitor site for redness/drainage. Use sterile technique for dressing changes. Occlusion don't force flush. Inflammation.

Created by: Wasurenboh

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